43 yo M PA with difficult HTN and low K for X years. Neg CT scan and renin and aldo results. Doing better on spiro/DASH (if true

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Not sure I understand the first part of the question. ACE, BB, and clonidine, in addition to trials of verapamil, hydrazaline, and HCTZ plus some newer samples of HTN meds, at times, I knew didn't work because they didn't work. I have monitored my blood pressure mutliple times a day for years on the same machine that I frequently calibrate and I have staff take it too and compare. With my pressure as high as it was I was afraid to not take them too.

Now, clonidine has that withdrawal issue and I had tried to stop it many times, but then it would increase my BP and heart rate and they always asked me to go back on it (and it's amazing how many providers and nurses often thought I had said "Klonopin" anyway - an easy mistake I guess). Or maybe they held something in check if we consider my BP could have gone higher possibly.

But recently, since DASH, and I consulted a dietician, which I am still learning how to get it right with the family on board, and the spiro, I no longer need them and had some little w/d feelings but no rebound HTN this time. When I still took the ACE and the spiro (50mg qd) my BP had actually gone too low +/-100/50 recently and the dizziness was intense. So I stopped the ACE very recently though I still take metoprolol occasionally due to heart rate issues.

Not sure why the rate is up at times as thyroid is normal now (or registering as such) and my recent heart studies have been normal, except for a new systolic murmur - hypertrophy is now minimal on my last scan and echo and I do not know if it actually is or not as I do not have the old studies and records to compare it to. Just what the previous echo and ct showed in 2008 I don't know was told but didn't read the reports that I had significant hypertrophy.

I stayed on the BB. and ACE due to the hypertrophy and remodeling benefit over the years though they did not seem to work for HTN. BB was not consistent as I tried a few times over the past 3 years and would have to stop it as even the lowest dose dropped my heart rate, often into the high 40's. Only after we discovered the hyperthyroidism (officially in april of 2010 )did I start back on the BB and had almost instant relief of the rapid rate and anxiousness related to the hyperthyroid. Zero effect at lowering bp though

I pub med, medscape, and google terms like "PA, hyperthyroid, DASH, etc" and before I was dx'd I was always looking up topics and terms such as "HTN; hypokalemia, etc" in various combo's. All of my CME has been focused on these topics lately. I do most of my CME through medscape.

Since part of the American Heart Association job is to educaute us about high blood pressure. They say that one out of ten with it also have PA why don't they educaute ever one about this? > > > > Subject: 34F - High Aldo, High Renin - ER Visit Last Night> To: hyperaldosteronism > Received: Friday, January 7, 2011, 10:02 AM> > > Â > > I've been following the posts but

haven't posted in awhile on myself as there hasn't been much to post. The Dr. at Loma is still running tests (slowly I might add...like one test every 6-8 weeks grrrr!!!!). He believes its Secondary Aldo, but still no idea whatsoever what is causing it. In the mean time my primary Dr. is sending me to a Rheumatologist for testing for fibromyalgia. > > But the last two weeks I've been feeling really off. The last week I've been having chest palps and pain again, initially kinda of mild so figured my potassium must be a bit low. I'm still on the 40MEQ of potassium. Well yesterday I went to work after taking a couple days off due to feeling so poorly and scared the hell out of my coworkers yesterday afternoon when my chest pain went from mild to SEVERE and radiating up to my shoulder. I got extremely dizzy, and nearly

passed out. They rushed me to the ER where I got the worst treatment I have ever experienced at my local hospital (yes I have been there before and have never been much impressed with them).> > Corona Regional Hospital (never go to them!)did immediately take an EKG which according to them "didn't show any abnormalities" even though I could feel my heart skipping a beat! My blood pressure, the first time they took it was 201/120!! They then put me in the waiting room! Finally an HOUR later, a PA talked to me for all of 3 minutes, said they were "extremely busy" and would call me for blood work soon. Half an hour later they called me in for a chest xray. Half an hour after that, blood work. All the while still sitting in the waiting room with a bunch of people with the flu. Then almost 2 hours later they finally put me in a bed. The ER Dr. came in, asked all of maybe 3 questions, told

me that the EKG and blood work did not show a heart attack, that my Potassium was "only slightly low at 3.3" and they would give me potassium and send me home immediately. I asked about my blood pressure, he said to see my regular Dr. since it had come down (to ONLY> 172/103!) I asked about the skipped heart beats that I could clearly make out on the heart monitor I was on, and he told me "it might be caused by the slightly low potassium, but really the potassium wasn't that low and that I wasn't having a heart attack, so go home!" They never game me anything to bring down my blood pressure and didn't even address it! > > I thought blood pressure that high is considered an hypertensive emergency. I am still feeling very bad this morning, despite the extra potassium, still having chest pains/palps and skipped beats,

shortness of breath, severe headache and dizziness. I have called my primary Dr's office (my primary isn't in on Fridays) and they are having me come in this afternoon. I am sick of these dr's taking their sweet time to determine what is wrong with me!>

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